Complex skin cancer treatment requiring reconstructive plastic surgery: an interview study on the experiences and needs of patients

Abstract

To provide patient-centered care, it is essential to explore what patients consider important and to adjust care accordingly. This may specifically be relevant for patients with complex skin cancer, for whom the care process is often more complicated and psychological and social problems may play a larger role. The objective was to explore the experiences and needs of patients who had undergone surgical treatment by a dermatologist for a complex skin cancer with a subsequent reconstruction by a plastic surgeon. An interview study was conducted among 16 patients who had undergone surgical treatment by a dermatologist and reconstruction by a plastic surgeon for basal cell carcinoma, cutaneous squamous cell carcinoma, or lentigo maligna. The interviews focused on patients’ experiences and needs regarding care using a predefined topic list. All interviews were audio-taped, transcribed verbatim and inductively analyzed using Atlas.ti. Patients reported a need for a skilled and friendly physician who tailors information and communication to their individual situation. A need for continuity of care and improved collaboration between healthcare providers was also emphasized. Furthermore, patients experienced complications and unmet expectations and expressed a need for shared decision-making at various steps throughout the treatment process (depending on age). Patients also considered completeness of tumor removal, follow-up visits with multiple specialists to be planned the same day and recognition of the psychological impact of the disease on the partner important. To improve patient-centered care for complex skin cancer patients, more efforts should be directed towards improving continuity of care and collaboration. Furthermore, it is advocated for physicians to be sensitive to the individual needs of patients and their partner and adjust information, communication and (supportive) care accordingly.

Long-Term Patient-Reported Outcomes following Oncological Facial Reconstructive Surgery using the FACE-Q Skin Cancer Module

“… 4 Facial defects that occur following surgical treatment of skin cancer, using Mohs micrographic surgery (MMS), are usually challenging to repair and require a multidisciplinary approach; a plastic and reconstructive surgeon may provide the best care for these patients. 5 , 6 Refinements in plastic surgery techniques have improved functional and aesthetic outcomes following facial reconstructions. 4 , 7 , 8 …”

Implementation Science in Surgery: Translating Outcomes to Action

“…Plastic surgeons have applied a diverse array of experimental methods to further investigate patient-centered care ranging from qualitative studies to conjoint analyses. [9][10][11][12] In an analysis of the needs of patients requiring plastic and reconstructive surgery after complex skin cancer treatment, the authors interviewed patients receiving care from surgeons for reconstruction after basal cell carcinoma, cutaneous squamous cell carcinoma, or lentigo maligna to learn about their experiences and needs regarding care. The participants explained that tailored health care information, collaboration among subspecialists, coordinated follow-up visits, and shared decision-making throughout the entire perioperative period were integral components to their care.…”

Application experience and research progress of different emerging technologies in plastic surgery

“…People seeking cosmetic surgery choose plastic surgery because they seek a higher standard of beauty, and their expectations of the procedure are high. Therefore, plastic surgery, unlike other disciplines, requires a high degree of accuracy[ 1 ]. Patients usually lack a concrete sense of the outcomes of a procedure before surgery.…”